Provision of Learning Objectives and Requirement Checklist to Residents

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Name*

First Last

Email*

Enter Email Confirm Email

Workday Number*

Clerkship for which I am Course Director*

Family Medicine

Geriatrics

Internal Medicine

Neurology

Obstetrics/Gynecology

Pediatrics

Psychiatry

Surgery

As clerkship director, I ensure that all residents (my department, other departments, transitional year, visiting residents, etc.) who work with medical students in my clerkship are provided the learning objectives and requirement checklist.

I attest to the above statement*

Yes